Alberta s Occupational Health and Safety Regulations An Explanation of the New First Aid Regulation

Alberta s Occupational Health and Safety Regulations An Explanation of the New First Aid Regulation SECOND EDITION Prepared by: Workplace Health and Safety May 2001

Table of Contents Purpose of the First Aid Regulation... 1 First Aid Regulation... 4 Section 1 Definitions... 4 Section 2 Employer Responsibilities... 7 Section 3 Prime Contractor Responsibilities... 12 Section 4 Co-operation on Responsibilities... 12 Section 5 Location of First Aid Services, Equipment, Supplies... 13 Section 6 Transportation... 15 Section 7 Location of First Aid Providers... 19 Section 8 Record of First Aid Providers... 20 Section 9 Duty To Report Accident, Illness... 20 Section 10 Record of Accident, Illness... 21 Section 11 Access to Records... 22 Section 12 First Aid Training... 24 Section 13 Corrosive Chemicals... 25 Section 14 Application for Acceptance... 26 Section 15 Transitional... 27 Section 16 Consequential... 28 Section 17 Repeal... 28 Section 18 Expiry... 29 Section 19 Coming into Force... 29 SCHEDULE 1 Low Hazard Work... 30 SCHEDULE 2 High Hazard Work... 30 SCHEDULE 3 First Aid Equipment and Supplies... 32 SCHEDULE 4 First Aid Room Requirements... 34 SCHEDULE 5 First Aid Room Requirements for a Temporary or Mobile Facility... 36 SCHEDULE 6 First Aid Requirements for a Low Hazard Site... 38 SCHEDULE 7 First Aid Requirements for a Medium Hazard Site... 39 SCHEDULE 8 First Aid Requirements for a High Hazard Site... 41 Index... 45

Purpose of the First Aid Regulation Alberta s newest edition of the First Aid Regulation (AR 48/2000) came into effect on March 31, 2000. The purpose of the Regulation is to ensure that every work site in the province has the equipment, supplies, and trained staff to be able to provide first aid care in the event of workplace illness or injury. The Regulation specifies minimum requirements; employers are free to exceed them. In some cases, employers will have unique first aid needs requiring additional specialized knowledge, equipment, and supplies. The employer should perform a site-specific hazard assessment to identify these needs. The hazard assessment reviews the hazards that workers are exposed to during their work to make sure that the employer s first aid services can deal with the illnesses or injuries most likely to occur during that work. The purpose of this publication is to explain the requirements of the Regulation in plain, easy-to-understand language. Each of the rules or sections of the Regulation is presented, followed by information that helps to clarify the intent or application of the section. This second edition includes new information further explaining sections 2 and 6 of the Regulation. Compared to its previous edition, many changes have been made to the Regulation. The following is a summary of the major changes: Requirements for First Aid Training Agencies Under the old First Aid Regulation, training for first aiders had to be provided by the St. John Ambulance Association or by another agency with a program considered to be equivalent. In the new Regulation, training for first aiders can be provided by a variety of agencies provided that they have entered into an agreement with the Director of Medical Services for Alberta Human Resources and Employment, Workplace Health and Safety. A condition of this agreement is that training programs must meet the standards adopted by the Director in consultation with the newly created Joint First Aid Training Standards Board. No specific agencies are listed in the Regulation. Instead, a list of accredited training providers will be posted on the Alberta Human Resources and Employment, Workplace Health and Safety Internet Web site at www.whs.gov.ab.ca when the list is completed. Employers can still use training agencies approved under the old Regulation until August 31, 2000, after which time they must only use agencies approved under the new system. New Requirements to Consider the Distance From a Health Care Facility as a Factor in Assessing First Aid Services Under the old Regulation, the distance from the work site to the nearest health care facility was not considered when determining the first aid services, equipment, and supplies that had to be provided by the employer. The new Regulation now considers this distance when assessing these needs. FA008 Second Edition May 2001 1

Modified First Aid Kit Contents The required contents of first aid kits in the new Regulation has been modified to reflect changes in first aid practices and the need to prevent a first aider from contacting blood or body fluids. Employers must purchase additional supplies if they only have the minimum equipment required by the old Regulation. Protection of Worker Privacy The list of information that must be recorded in the employer s first aid treatment book in the event of a worker s illness or injury has changed. Personal information like date of birth and sex have been dropped to protect the worker s privacy. The new Regulation also limits access to first aid records. Only the worker and those involved in medical treatment, work site inspections, accident and incident investigations, the evaluation of the employer s work site health and safety program, or the Workers Compensation Board, may review the records. Allowance to Use Paramedics Instead of Nurses at Larger Work Sites The new Regulation allows employers to use qualified Emergency Medical Technician-Paramedics in place of nurses at larger work sites. Paramedics must be recognized by the Alberta College of Paramedics. Administrative Changes New terms describing first aiders have been introduced and are summarized in Table 1. These new terms provide a better description of the level of training each designation receives. The training times required to achieve a particular qualification do not change under the new Regulation. Table 1 Equivalency of first aider designations Term Used in Old First Aid Regulation Term Used in New First Aid Regulation First Aid Attendant Advanced First Aider First Aider II Standard First Aider First Aider I Emergency First Aider The new Regulation has been simplified by combining the requirements for dispersal sites and office or administrative sites. The reference to principle contractor has been replaced with prime contractor to reflect changes to the Occupational Health and Safety Act. FA008 Second Edition May 2001 2

Need More Information? An Explanation of the New First Aid Regulation This publication provides explanations that apply to most workplaces and situations. However, if an explanation is unclear, or additional information would be helpful, Alberta Human Resources and Employment, Workplace Health and Safety would like to know. Please call us at (780) 427-2687 so that we can answer your questions and incorporate the answers into the next edition of this publication. Looking for Help in Your Area? Contact the Alberta Human Resources and Employment, Workplace Health and Safety Call Centre by dialling toll-free: 1-866-415-8690 Note: All persons making use of this publication are reminded that it has no legislative sanction. The original Regulation should be consulted for all purposes of interpreting and applying the law. FA008 Second Edition May 2001 3

First Aid Regulation Section 1 Definitions In this Regulation, (a) Act means the Occupational Health and Safety Act; (b) acute illness or injury means a physical injury or sudden occurrence of an illness that results in the need for immediate temporary care; (c) advanced first aider means a person who holds a certificate in Advanced First Aid Level #1 from a training agency or who is an Emergency Medical Responder (E.M.R.) or Emergency Medical Technician (E.M.T.); (d) close work site means a work site that is not more than 20 minutes travel time from a health care facility under normal travel conditions using the available means of transportation; (e) distant work site means a work site that is more than 20 minutes, but less than 40 minutes, travel time from a health care facility under normal travel conditions using the available means of transportation; (f) emergency first aider means a person who holds a certificate in Emergency First Aid from a training agency; (g) Emergency Medical Responder means a graduate of a training course at the Emergency Medical Responder (E.M.R.) level who is a member of the Alberta College of Paramedics; (h) Emergency Medical Technician means a graduate of a training course at the Emergency Medical Technician (E.M.T.) level who is a member of the Alberta College of Paramedics; (i) Emergency Medical Technician-Paramedic means a graduate of a training course at the Emergency Medical Technician-Paramedic (E.M.T.-P.) level who is a member of the Alberta College of Paramedics; (j) first aid means the application of accepted principles of treatment to sustain life, prevent a condition from becoming worse, and to promote recovery using available equipment, supplies, facilities and services to provide immediate and temporary care to an injured or ill worker; (k) first aider means a person who is designated by an employer to provide first aid to workers at a work site and who is an emergency first aider, standard first aider or advanced first aider; FA008 Second Edition May 2001 4

(l) health care facility means a hospital, medical clinic or physician s office that has the capability of dispensing emergency medical treatment 24 hours a day; (m) high hazard work means work described in Schedule 2; (n) isolated work site means a work site that is more than 40 minutes travel time from the work site to a health care facility under normal travel conditions using the available means of transportation; (o) Joint First Aid Training Standards Board means a board (i) (ii) that is established under Section 7 of the Government Organization Act by the Minister to advise the Director of Medical Services on the standards to be adopted for the first aid training required by this Regulation, and that includes representatives from the four national first aid training standard setting agencies; (p) low hazard work means work described in Schedule 1; (q) medium hazard work means work that is neither low hazard work nor high hazard work; (r) nurse means a graduate of an approved registered nursing program who maintains membership and good standing with the Alberta Association of Registered Nurses and is an advanced first aider; (s) standard first aider means a first aider who holds a certificate in Standard First Aid from a training agency; (t) training agency means a person or organization that enters into an agreement with the Director of Medical Services to deliver first aid training that meets standards that the Director of Medical Services adopts in consultation with the Joint First Aid Training Standards Board, for a certificate in Emergency First Aid, Standard First Aid or Advanced First Aid Level #1. Explanation Section 1 A number of words and terms are used in the Regulation and are defined in Section 1 understanding them is key to being able to use the Regulation. Only those definitions that appear to require additional explanation are shown below. Act Act refers to Alberta s Occupational Health and Safety Act. The Act sets standards to protect and promote the occupational health and safety of workers throughout Alberta. It describes the rights FA008 Second Edition May 2001 5

and responsibilities of employers, workers, and others connected with the work site. The First Aid Regulation derives its authority from the Act and states the rules applicable to first aid services, equipment, and supplies at Alberta workplaces. close work site, distant work site, isolated work site For the purposes of this Regulation, work sites are classified based on the length of time it takes to get an ill or injured worker from the work site to a health care facility under normal travel conditions. In most situations, normal travel involves the use of a vehicle on some type of roadway under weather and road conditions that are usually and frequently experienced at that work site. In some situations however, normal travel may involve the use of a boat, aircraft, or helicopter. Classifying a work site as close, distant, or isolated helps establish the first aid services, equipment, and supplies required at the work site. Emergency Medical Responder, Emergency Medical Technician, Emergency Medical Technician-Paramedic Alberta s Emergency Medical Technician Regulation requires that a person having any one of these designations must be a member of the Alberta College of Paramedics. A person registered as an Emergency Medical Technician-Ambulance (E.M.T.-A.) may use the name Emergency Medical Technician (E.M.T.). The services that can be provided by an Emergency Medical Responder, Emergency Medical Technician, Emergency Medical Technician- Ambulance, or Emergency Medical Technician- Paramedic are listed in the Emergency Medical Technician Regulation and must be administered under the direction of a physician. first aid The key words in this definition are immediate and temporary. First aid must be provided quickly and is intended to support the ill or injured worker until complete medical care and treatment can be administered. The Regulation does not expect employers to offer complete medical care and treatment. Most often, first aid is provided to prevent a condition from becoming worse. Far less frequently it is provided to sustain life. health care facility In many instances, the health care facility will be a hospital. Smaller hospitals, medical clinics, and physician s offices meet the condition of dispensing emergency medical treatment 24 hours a FA008 Second Edition May 2001 6

day if a physician is on-call on nights and weekends. The key consideration is that medical treatment can be administered when needed. If a work site is not in operation 24 hours a day, then the health care facility to which an ill or injured worker would be sent only needs to provide emergency medical treatment services during the hours that workers are at the work site. This includes workers when they are accommodated at the site. Joint First Aid Training Standards Board This Board advises and provides assistance to the Director of Medical Services on issues involving the curriculum adopted for the first aid training required by the Regulation. The Director is an occupational health physician who works on behalf of Alberta Human Resources and Employment, Workplace Health and Safety. The four national training agencies represented on the Board are the Alberta Council of St. John Ambulance Association, the Alberta and Northwest Territories Branch of the Lifesaving Society, the Canadian Red Cross, and the Canadian Ski Patrol. training agency First aider training can only be provided by agencies that have entered into a written agreement with the Director of Medical Services. This agreement includes review of course content, training materials, and course duration. Refer to Section 12 of this publication for more information. Section 2 Employer Responsibilities Employers must, as required by this Regulation, provide first aid services and maintain first aid equipment and supplies at the work site for their workers and a first aid room. Explanation Section 2 First Aid Services The Occupational Health and Safety Act requires employers to protect the health and safety of workers performing work for them, as well as the health and safety of other workers present at the work site where the work is being performed. In fulfilling this obligation, the employer is responsible for ensuring that first aid FA008 Second Edition May 2001 7

services, equipment, and supplies are available at the work site. In a limited number of cases, a first aid room must also be provided. The type of first aid services an employer must provide is based on three criteria - how hazardous the work is, the time taken to travel from the work site to a health care facility (a measure of the remoteness of the work site), and the number of workers on each shift. To determine if the work performed is low, medium, or high hazard work, refer to Schedules 1 and 2 of the Regulation. According to the Schedules, work that is neither low or high hazard is classified as medium hazard work. For the purposes of this Regulation, work sites are classified based on the length of time it takes to get an ill or injured worker from the work site to a health care facility under normal travel conditions. In most situations, normal travel involves the use of a vehicle on some type of roadway under weather and road conditions that are usually and frequently experienced at that work site. In some situations however, normal travel may involve the use of a boat, aircraft, or helicopter, as might be the case at a remote work camp. When determining the classification of a work site, consider the means of transportation usually and frequently available. If a roadaccessible work site is serviced by a helicopter once every few days, then the travel time to the health care facility should be based on the time taken by a vehicle to travel the distance, not the helicopter. The helicopter is not usually and frequently available for the transport of an ill or injured worker. Classifying a work site as close, distant, or isolated helps establish the first aid services, equipment, and supplies at the work site. The required services, equipment, and supplies are listed in Schedules 6, 7, and 8. The final criterion for establishing the type and level of first aid services to be provided is the number of workers on each shift. Schedules 6, 7, and 8 provide this information. Figure 1 presents a flow chart for determining the type of first aid services that must be provided at a work site. Work Site and Worker Subsection 1(n) of the Occupational Health and Safety Act defines a work site as a location where a worker is, or is likely to be, engaged in any occupation. For workers who work out of their vehicle, any vehicle or mobile equipment used by the worker as part of the job is also considered a work site. The Act clearly indicates that a work site is any location where there is, or is likely to be, a worker doing work as part of their occupation. Subsection 1(m) of the Occupational Health and Safety Act defines a worker as any person engaged in an occupation. It is not necessary for the worker to be paid and therefore volunteers and other unpaid persons are considered to be workers. FA008 Second Edition May 2001 8

Exempted workers The amendment, as well as the GSR, do not apply to farmers and ranchers, workers working in their own private dwellings, domestic workers such as nannies and housekeepers, federal government workers, or workers in federally-regulated industries such as banking, telecommunications, television and radio broadcasting, and interprovincial transportation. Are students workers? The Occupational Health and Safety Act covers any worker engaged in an occupation. The Act goes on to define occupation to mean every occupation, employment, business, calling or pursuit over which the Legislature has jurisdiction. In creating this broad definition, legislators wanted to ensure that all those engaged in hazardous work activities were protected by the Act, even if they receive no payment for that work. Under the Act, the employer is responsible for ensuring workers health and safety and workers are subject to the duties and protections provided for under the Act. In applying this legislation to students, the Act is intended to apply to: students undertaking on-the-job work experience programs; students in traditional workplace-type settings such as machine, woodworking and automotive shops, cosmetology, chemistry, engineering and electronic labs, and food and meat production areas that might typically be found in technical schools, universities, and apprenticeship and vocational programs; students who perform work on behalf of, for example, an academic institution or instructor; and since it is not necessary for workers to be paid, students who perform work as volunteers on behalf of, for example, an academic institution or instructor. Workplace Health and Safety enforces the Act in these situations. The Department would not apply the Act in the following situations because they do not expose students to hazards normally associated with on-the-job work experience programs or the traditional workplace-type settings described above: students enrolled in elementary schools, unless students participate in activities that take place in workplace-type settings ; students engaged in pure academic study in a classroom setting (e.g. lecture hall, computer lab, language lab); and students engaged in extracurricular activities not directly related to their career (e.g. sports and fitness programs, club activities). FA008 Second Edition May 2001 9

Do students have an employer? Students considered to be workers under the Act but who do not receive payment for their work and are not volunteers are considered to be self-employed (e.g. students undertaking on-thejob work experience programs). This places the burden of complying with the Act and its associated regulations largely on the students themselves. Responsibilities of the educational institution Educational institutions are not without obligations. In accordance with the Act, an educational institution is the prime contractor for the work site and the self-employed workers working there i.e. the students. As a result, the educational institution is responsible for: (a) ensuring, as far as reasonably practicable, compliance with the Act; and (b) ensuring first aid services and equipment are provided for the maximum number of workers actively involved in work at the academic institution at any one period of time. FA008 Second Edition May 2001 10

Figure 1 Determining first aid requirements What type of work is performed at the work site? Is it low hazard work as listed in Schedule 1? NO NNO Is it high hazard as listed in Schedule 2? NO The Regulation considers the work to be medium hazard YES YES YES What is the travel time to the nearest health care facility? < 20 minutes (Close Work Site) 20-40 minutes (Distant Work Site) >40 minutes (Isolated Work Site) What is the travel time to the nearest health care facility? < 20 minutes (Close Work Site) 20-40 minutes (Distant Work Site) >40 minutes (Isolated Work Site) What is the travel time to the nearest health care facility? < 20 minutes (Close Work Site) 20-40 minutes (Distant Work Site) >40 minutes (Isolated Work Site) How many workers per shift? 1? 2-10? 11-49? 50-99? 100-199? >200? How many workers per shift? 1? 2-10? 11-49? 50-99? 100-199? >200? How many workers per shift? 1? 2-10? 11-49? 50-99? 100-199? >200? Section 3 Prime Contractor Responsibilities Use Schedule 6 Use Schedule 8 Use Schedule 7 A prime contractor must ensure that the first aid services, first aid equipment and supplies and a first aid room, as required by this Regulation, for the type of work site and the total number or workers at the work site are available at the work site. FA008 Second Edition May 2001 11

Section 3 Prime Contractor Responsibilities A prime contractor must ensure that the first aid services, first aid equipment and supplies and a first aid room, as required by this Regulation, for the type of work site and the total number of workers at the work site are available at the work site. Section 4 Co-operation on Responsibilities Despite sections 2 and 3, the employers and prime contractors at a project may enter into a written agreement to collectively provide first aid services and maintain first aid equipment and supplies for workers in accordance with this Regulation Explanation Sections 3 and 4 Prime Contractor According to the Occupational Health and Safety Act, every work site must have a prime contractor if there are 2 or more employers working at the work site at the same time. The prime contractor for a work site is the contractor, employer, or other person who enters into an agreement with the owner of the work site to be the prime contractor. This prime contractor is responsible for making sure that appropriate first aid services, equipment, and supplies are available at the work site as required by this Regulation. The services, equipment, and supplies must be available and accessible during all working hours as required by Section 5(a)(ii) of this Regulation. Schools as Prime Contractors Under the Occupational Health and Safety Act, a school is considered to be a work site if it is attended by students training for an occupation and the school itself is considered to be a prime contractor. The first aid services, equipment, and supplies that the school must provide is based on the number of workers at the school staff and support staff and the number of students considered to be workers. Example: Approximately 1000 students attend a high school. Of these, 6 are involved in a hospitality services program, 50 attend an automotive mechanics program, 24 attend a graphics program, and 30 attend a cosmetology program. The remainder are involved in purely academic studies i.e. english, math, science, etc. Sixty staff and support staff work at the school. The total number of workers at the high school is therefore 170 (6+50+24+30+60). FA008 Second Edition May 2001 12

Because the school is neither a high hazard nor low hazard work site, it is considered to be a medium hazard work site. Sharing Responsibilities Section 4 allows employers and prime contractors to jointly supply first aid services to the work site. Such a sharing of responsibilities and resources must be described in a written agreement, and must be based on the total number of workers at the work site. Example: Construction company ABC has 100 workers working at a work site. According to Schedule 2 of this Regulation, construction is considered to be high hazard work. Assuming that the work is performed at a Close Work Site, then according to Schedule 8 the employer must provide 2 Emergency First Aiders, 2 Standard First Aiders, and 1 Advanced First Aider. If construction company XLR has 100 workers and also begins working at the same work site, then the site requires a prime contractor and the first aid requirements for the site are based on 200 workers. According to Schedule 8, the prime contractor must provide 2 Emergency First Aiders, 3 Standard First Aiders, and either 1 nurse or 1 E.M.T.-P. By cooperating on their responsibilities, the two employers can share resources, avoid duplication of first aid services, and maintain the required first aid coverage. Section 5 Location of First Aid Services, Equipment, Supplies An employer and prime contractor must (a) ensure that first aid services, first aid equipment, supplies and the first aid room required by this Regulation are (i) located at or near the work site that they are intended to serve, and (ii) available and accessible during all working hours, and that the equipment and supplies are (iii) (iv) (v) maintained in a clean, dry and serviceable condition, contained in a material that protects the contents from the environment, and clearly identified as first aid equipment and supplies, (b) post, at conspicuous places on the work site, signs indicating the location of first aid services, equipment and supplies or, if posting of signs is not practicable, ensure that each worker knows the location of first aid services, equipment and supplies, and FA008 Second Edition May 2001 13

(c) ensure that an emergency communication system is in place for workers to summon first aid services. Explanation Section 5 First Aid Room The employer is responsible for ensuring that first aid services, equipment, and supplies are available at the work site. A first aid room need only be provided in cases where (a) there are 200 or more workers per shift performing medium hazard work (see Schedule 7), or (b) there are 100 or more workers per shift performing high hazard work (see Schedule 8). Schedule 4 lists the requirements for a permanent first aid room; Schedule 5 lists the requirements for a first aid room that is temporary or mobile. Equipment and Supplies First aid services, equipment, and supplies must be quickly and easily accessible during all working hours. First aid equipment and supplies must be ready for use and protected from the elements so that their usefulness is not affected by exposure to heat, cold, wind, and moisture. The equipment and supplies, or more often the containers in which they are stored, must be clearly marked to indicate that they are intended for first aid. Informing Workers If signs are posted at the work site to indicate the location of first aid services, equipment, and supplies, the signs should be visible, easy to understand, and appropriate to the work force. Where signs are not practicable, workers must be informed of the location of the services, equipment, and supplies by other means such as printed materials or verbal instructions. If members of the workforce have difficulty reading or understanding English, signs and printed materials (if they are used) should use easily understood symbols or include translations. Verbal instructions should be provided to workers in the language they understand, perhaps through a co-worker acting as interpreter. Emergency Communication System Employers are required to have in place an emergency communication system so that first aid services can be summoned to an ill or injured worker. The selection of the system or approach to providing emergency communication is at the discretion of the FA008 Second Edition May 2001 14

employer. It may involve the use of telephones, cellular telephones, satellite telephones, portable 2-way radios, or other means that are equally effective. The intent of the requirement is to make sure that ill or injured workers can access first aid services quickly and reliably Section 6 Transportation (1) An employer must ensure that, prior to the dispatch of workers to a work site, arrangements are in place for transportation of injured or ill workers from the work site to the nearest health care facility. (2) An employer must ensure that transportation is available for transport of injured or ill workers to a health care facility that meets the following requirements: (a) (b) an ambulance service is available for the work site under normal travel conditions; a means of transportation is available from the work site that (i) (ii) (iii) (iv) is suitable, considering the distance to be travelled and the types of acute illness or injuries that may occur at the work site, affords protection against the weather, is equipped with a means of communication with the health care facility to which the injured or ill worker is being transported and the work site, and is of sufficient size and suitability to accommodate a stretcher and an accompanying person where required. (3) An employer must provide a means of communication to summon the ambulance service or transportation described in subsection (2). (4) If a worker is acutely ill or injured, or needs to be accompanied during transport to a health care facility, an employer must ensure that the worker is accompanied by at least one first aider, other than the operator of the transportation. Explanation Section 6 Application Section 6 requires employers to ensure that a means of transportation is available for transporting injured or ill workers to a health care facility when needed. This section applies to all work sites, regardless of the number of workers, the hazard level of the work or the distance of the work site to a health care facility. It also applies to all work sites regardless of any service, supply or equipment requirements specified elsewhere in the regulation. FA008 Second Edition May 2001 15

Subsection 6(1) Subsection 6(1) requires employers to ensure that transportation arrangements are in place for transporting injured or ill workers from a work site to the nearest health care facility. Before an employer sends workers to any work site and work begins, the employer needs to have a plan in place for taking injured or ill workers from the work site to a health care facility. This plan should be in writing and available for review by any Occupational Health and Safety Officer from Alberta Human Resources and Employment, Workplace Health and Safety. Guidance on what to consider when developing the plan and what an Officer will look for during the review is presented under the heading Transportation Plan. Subsection 6(2) Subsection 6(2) offers employers two potential options when deciding the type of transportation to have available for injured or ill workers. The first is that an employer can use an ambulance service. The service must be capable of arriving at the work site within 40 minutes of being called. If this is not possible, the second option available to employers is to have a means of transportation from the work site that meets all the requirements listed in subsection 6(2)(b), namely: (1) it must suit the distance to be travelled and the types of injuries or illnesses that may occur. The means of transportation must make transport of the ill or injured worker safe and comfortable. It should be clean and if serious injuries are likely to occur, as in a high hazard industry, then the means of transportation needs to accommodate a seriously injured worker in a manner that prevents additional injuries and provides timely transport; (2) the available transportation must protect the injured worker and an accompanying person from weather. If workers are at an isolated site and work is done during cold, wet or other inclement weather, then the means of transportation must provide sufficient heat to keep both individuals warm and be enclosed or covered; (3) the means of transportation must be equipped with a means of communication with the health care facility to which the injured or ill worker is being transported. This could be a cellular telephone, vehicle-based 2-way radio or whatever is most practicable as long as it permits communication with the health care facility; and (4) the means of transportation must be large enough to accommodate a stretcher and accompanying person. Many stretchers are 200 or more centimetres long (80 in) so the available space must accommodate this. Stretchers must be secured during transport to protect the safety of the injured worker and accompanying person. FA008 Second Edition May 2001 16

If a public or private ambulance service is not available, the employer may decide to provide an emergency response vehicle that can respond to more than one work site. This vehicle must be able to arrive at any work site it is intended to serve within 40 minutes of being called. Otherwise, there must be a means of transportation from the work site that meets the 4 requirements listed above. This means of transportation should be maintained in a clean condition and be available to respond when called. The emergency response vehicle could be a van, truck, boat, aircraft or any other means that meets all the requirements. Subsection 6(3) The employer must have a means of communication in place at the work site that allows an ambulance or other means of transportation to be summoned. The particular means of communication provided is at the employer s discretion but it must be capable of summoning an ambulance or transportation service quickly and reliably. Communication may be through the use of a telephone, cellular telephone, satellite telephone, portable 2-way radio or any other means that is effective. Subsection 6(4) If a worker is acutely injured or ill, or needs to be accompanied during transport to a health care facility, the worker must be accompanied by at least one first aider, other than the operator of the means of transportation. The accompanying person must be a first aider, but the level of first aid training required of this first aider is not stipulated. To determine which first aider should accompany the injured worker, consider the level or type of injury or illness, the distance to be travelled, the mode of transportation used and the level of first aid services that must continue to be offered at the work site. Transportation Plan Factors to consider Before an employer sends workers to any work site and work begins, the employer needs to have a plan in place to transport injured or ill workers from the work site to a health care facility. The transportation plan must consider the following factors, many of which are the same as those considered when developing the complete First Aid Program: (a) the types of injuries or illnesses likely to occur given the hazards inherent to the work and the ages and limitations of the workers; (b) the number of workers at the work site; (c) the distance to be travelled from the work site to the health care facility; FA008 Second Edition May 2001 17

(d) the availability of a local ambulance service; (e) ambulance or emergency vehicle response times; (f) the time(s) of day that the work site is in operation; (g) the means of transportation needed to get to the work site; (h) transportation routes; (i) seasonal or weather changes that may affect the means or routes of transportation; and (j) travel times. When developing a plan, prospective ambulance services should be contacted in advance to find out the processes involved in responding to a call and the expected response times. Particularly at isolated work sites, response times may vary considerably depending on the type of day, the weather and other factors. If a work site s plan involves calling an emergency response centre that dispatches local air ambulances for example, consider that local helicopter services may not have the equipment to navigate after dark and may not be able to accommodate a stretcher. Also, if a call centre is used as an emergency contact number and the call is re-routed to a local ambulance service, then the service must determine the location of the work site, resulting in a response delay that may exceed the 40 minute limit allowed. Ask specific questions of the ambulance services being considered when developing a plan. Determine the service s capabilities and likely response times. Find out whether the service will dispatch a helicopter or road ambulance. If the work site is accessible by road, it is reasonable to expect that a road ambulance will service it and this may add considerable time to the response. What Officers look for in a plan Once all factors particular to the industry and the work site have been considered, the written plan should be finalized and communicated to the workers to whom it applies. The written plan should be available to Occupational Health and Safety Officers upon request. Officers will look for the following in a written plan: (1) Who to call a list of the means of transportation that is to be used to transport injured or ill workers. The plan must specify whether an ambulance service is used, whether a means of transportation is summoned from a different location or whether on-site transportation is available. (2) How to call a clear statement of how the means of transportation will be summoned. List telephone numbers or radio channels as appropriate. (3) Who makes the call a clear statement of who may summon the emergency means of transportation FA008 Second Edition May 2001 18